From Classical Laboratory Parameters to Novel Biomarkers for the Diagnosis of Venous Thrombosis

Abstract

Venous thrombosis is a common and potentially fatal disease, because of its high morbidity and mortality, especially in hospitalized patients. To establish the diagnosis of venous thrombosis, in the last years, a multi-modality approach that involves not only imaging modalities but also serology has been evolving. Multiple studies have demonstrated the use of some biomarkers, such as D-dimer, selectins, microparticles or inflammatory cytokines, for the diagnosis and treatment of venous thrombosis, but there is no single biomarker available to exclusively confirm the diagnosis of venous thrombosis. Considering the fact that there are some issues surrounding the management of patients with venous thrombosis and the duration of treatment, recent studies support the idea that these biomarkers may help guide the length of appropriate anticoagulation treatment, by identifying patients at high risk of recurrence. At the same time, biomarkers may help predict thrombus evolution, potentially identifying patients that would benefit from more aggressive therapies. This review focuses on classic and novel biomarkers currently under investigation, discussing their diagnostic performance and potential benefit in guiding the therapy for venous thrombosis.

Keywords: D-dimer; E-selectin; P-selectin; biomarkers; diagnosis; microparticles; venous thrombosis.

Figure 1

The extrinsic and intrinsic pathway of coagulation and the formation process of D-dimer. Abbreviations: Roman numerals, the clotting factors; C, collagen; FB, foreign body; K, kallikrein; HK, high-molecular-weight kininogen; PL, phospholipid; TD, tissue damage; FM, fibrin monomer; FP, fibrin polymer; CF, crosslinked fibrin; F, fibrinolysinum.